Statin use at cancer diagnosis linked to lower mortality

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Docs questioning new statin guidelines
Docs questioning new statin guidelines

HealthDay News -- Statin use prior to cancer diagnosis correlates with reduced all-cause and cancer-related mortality, study results show.

In a nationwide analysis of patients with cancer in Denmark, statin users had a 15% reduced risk for cancer mortality compared with those who had not used the drugs at the time of cancer diagnosis, Sune F. Nielsen, PhD, from Copenhagen University Hospital in Denmark, and colleagues reported in New England Journal of Medicine.

A similar reduction in the risk for all-cause mortality was also observed, prompting the researchers to call for additional prospective clinical trials to examine the role of statins in cancer survival.

Previous research suggests that statins may influence the biochemical pathways involved in cancer growth and spread. To examine how statin users prior to cancer diagnosis fared compared with those who did not use the BP-lowering medications, Nielsen and colleagues analyzed statin prescriptions, cancer diagnoses and mortality among all Danes in a national registery who were diagnosed with cancer between Jan. 1, 1995 and Dec. 31, 2007. Patients were followed until Dec. 31, 2009.

The cohort included 18,271 patients aged 40 years or older, who had used statins regularly before diagnosis, and 277,204 patients who had never used statins. During 1,072,503 person-years of follow-up, 162,067 patients died of cancer, 14,489 of cardiovascular causes and 19,038 of other causes, the researchers reported.

Multivariable-adjusted hazard ratios were significantly lower for statin users compared with nonusers and were 0.85 each for death from any cause and death from cancer (95% CI: 0.82 to 0.87). Outcomes were similar regardless of the dose of statin given.

The corresponding hazard ratios for cancer-related mortality were 0.83, 0.87, and 0.87, respectively. For each of 13 cancer types there was reduced cancer-related mortality for statin users versus non-users.

However, the researchers cautioned that because the study involved a homogenous population of white Danish people, findings may not be generalizable to a wider population. They added that statin use may also signify greater health awareness, which may bias findings.

In an accompanying editorial, Neil E. Caporaso, MD, of the National Cancer Institute in Bethesda, Md., advised caution in interpreting the study findings.

"Although the findings suggest, with a few exceptions, that there were consistent and substantial declines in mortality across diverse cancers, there is no clear pattern of decreased mortality with increased dose," Caporaso wrote.

Before more clinical trials are undertaken, he said examining results of existing statin trials and cohorts would be useful to "to determine the agent, dose, and duration of follow-up," as well as "to establish both the recency and latency of the postulated effect."

Population studies are also needed to extend the results beyond Denmark, Caporaso argued, as well as basic science research to better understand mechanisms.


References

  1. Nielsen SF et al. N Engl J Med 2012; 367:1792-1802.
  2. Caporaso NE. N Engl J Med 2012; 367: 1848-1850.
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